Where you live counts a lot

Amanda Botticello, PhD, MPH, has been awarded a $400,000 grant from the Craig H. Neilsen Foundation to observe community activity spaces in order to better understand the influence of the environment on participation behavior among people with spinal cord injury (SCI). Research indicates that the physical environment, that is, places where individuals work and reside – is a key social determinant of health and disability.

The goal of this three-year project is to understand where and how daily activity outside the home occurs from the perspective of people living with severe mobility impairments. Participants will use Smartphones equipped with an application that logs community locations with GPS and an ecological momentary assessment (EMA) survey that logs participant activity. The application will capture individual resources, motivations, and strategies, as well as community supports and barriers.

“The information collected in this study will enable us to better understand how people with SCI have adjusted to life after injury and the role that the environment plays in their daily lives,” explained Dr. Botticello, senior research scientist in SCI and Outcomes & Assessment Research at Kessler Foundation. “We anticipate that this data will help guide the development of health promotion programs,” she added, “which will improve community reintegration for people with SCI who are at risk for social isolation.”

VASS (Ventilator Accommodation Support Service) is home for 20 people with degenerative diseases or injuries that require them to have 24/7 support from nurses and disability support workers. All these residents are in wheelchairs and use ventilators, to various degrees, to breathe.

When the idea of VASS came about, it was a bold, frankly quite outrageous idea, by a group of people in iron lungs in a wing of the Austin Hospital in Melbourne (Australia). They lobbied the government of the day to purchase land where two houses could be built.

These people wanted to have their own homes. Their clarity of purpose and determination they won the day. VASS was built and opened in 2007. The site was in a quiet street. next to a busy reserve along a creek.

Their environment was excellent. They could live the lives they wanted to live supported by nurses and disability workers. They had their own rooms, painted in the colour of their choice and shared a kitchen and living spaces. They could hear the Kookaburras and Magpies in the park and see the sunshine.

Unfortunately, over the last few years that vision has deteriorated. VASS has been hamstrung by bureaucracy and constant change of management. The living environment has gone downhill.

Now though, there is a new management team in place. Things are getting done. There is an air of excitement and anticipation. The environment is rapidly improving. We look forward to a more pleasurable environment for us all to live.